Update on the cytologic and molecular features of medullary thyroid carcinoma.

Details

Serval ID
serval:BIB_8E3D9106AEB3
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Update on the cytologic and molecular features of medullary thyroid carcinoma.
Journal
Advances in Anatomic Pathology
Author(s)
Pusztaszeri M.P., Bongiovanni M., Faquin W.C.
ISSN
1533-4031 (Electronic)
ISSN-L
1072-4109
Publication state
Published
Issued date
2014
Volume
21
Number
1
Pages
26-35
Language
english
Notes
Publication types: Journal Article ; ReviewPublication Status: ppublish
Abstract
Medullary thyroid carcinoma (MTC) accounts for only 5% to 10% of all thyroid carcinomas, but it is the most aggressive form of well-differentiated thyroid carcinoma, being responsible for 8% to 15% of all thyroid cancer-related deaths. MTC is frequently diagnosed at a locally advanced or metastatic stage, and 10-year survival rates in these cases are <20%. Fine-needle aspiration biopsy of the thyroid gland is an accurate method to diagnose MTC, having a high sensitivity and specificity. The cytologic features of MTC are characteristic and the cytologic diagnosis of classic MTC is often straightforward, especially when combined with immunocytochemistry. However, because of its morphologic heterogeneity and overlap with other tumors, the differential diagnosis of MTC on cytology and on histology is broad with several potential pitfalls. Significant advances have been made over the last decade in understanding MTC. This concerns mainly the early detection of MTC, especially in familial forms (eg, multiple endocrine neoplasia type 2), and the identification of key molecular pathways and alterations which now offer promising targets for specific therapies in progressive MTC cases. Genetic testing (eg, RET mutation) has allowed for early detection in asymptomatic carriers and high-risk patients, with prophylactic thyroidectomy often being curative. Targeted therapies with multityrosine-kinase inhibitors (eg, vandetanib or cabozantinib) have emerged as promising new treatments for recurrent or metastatic MTC. In this review article, we discuss the cytologic features of MTC and its variants, its differential diagnosis, the role of ancillary studies, and the salient molecular features of MTC.
Keywords
Humans, Thyroid Neoplasms/genetics, Thyroid Neoplasms/pathology
Pubmed
Web of science
Create date
21/01/2015 10:35
Last modification date
20/08/2019 14:52
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